Quiñones MA, Faza NN, Aoun J
… +4 more, Feher A, Kainat A, Parwani P, Patel AH
Methodist Debakey Cardiovasc J
· 2025 · PMID 41488790
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This 58-minute webcast features a conversation about "Coronary Artery Disease"-the focus of Issue 21.4. Led by the issue's guest editors, the discussion engages the authors on emerging themes and lessons learned while re...This 58-minute webcast features a conversation about "Coronary Artery Disease"-the focus of Issue 21.4. Led by the issue's guest editors, the discussion engages the authors on emerging themes and lessons learned while researching and writing the articles on Coronary Artery Disease. View the video at https://vimeo.com/event/5440083.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41425666
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A 19-year-old man with chest pain underwent cardiac magnetic resonance imaging (MRI), which identified a multilobulated cyst with internal septations located in the lateral left ventricular myocardium, consistent with a...A 19-year-old man with chest pain underwent cardiac magnetic resonance imaging (MRI), which identified a multilobulated cyst with internal septations located in the lateral left ventricular myocardium, consistent with a hydatid cyst. High-resolution cine and late gadolinium enhancement imaging demonstrated its structure and myocardial involvement. This case shows the capability of cardiac MRI in diagnosing rare cardiopericardial hydatid disease.
Quiñones MA, Martin C, Akay MH
… +3 more, Schlendorf KH, Yousefzai R, Young JB
Methodist Debakey Cardiovasc J
· 2025 · PMID 41424751
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This 62-minute webcast features a conversation about "Heart Transplantation"-the focus of Issue 21.3. Led by the issue's editor, the discussion engages the authors on emerging themes and lessons learned while researching...This 62-minute webcast features a conversation about "Heart Transplantation"-the focus of Issue 21.3. Led by the issue's editor, the discussion engages the authors on emerging themes and lessons learned while researching and writing the articles. View the video at https://vimeo.com/event/5134934.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41393087
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We report the case of a 79-year-old male with atypical chest pain where electrocardiogram-gated coronary computed tomography angiography (CTA) demonstrated a split right coronary artery with an intra-atrial course of the...We report the case of a 79-year-old male with atypical chest pain where electrocardiogram-gated coronary computed tomography angiography (CTA) demonstrated a split right coronary artery with an intra-atrial course of the posterior trunk. This case highlights the clinical implications of the rare anomaly and the importance of coronary CTA in detecting this unusual variant, which will be missed even on invasive coronary angiography.
Singh D, Pandey NN, Mukherjee A
… +2 more, Kadiyani L, Kumar S
Methodist Debakey Cardiovasc J
· 2025 · PMID 41278580
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We report a case of a 27-year-old female with supracardiac total anomalous pulmonary venous connection, where computed tomography angiography demonstrated a thin eccentric membranous web at the junction of the common cha...We report a case of a 27-year-old female with supracardiac total anomalous pulmonary venous connection, where computed tomography angiography demonstrated a thin eccentric membranous web at the junction of the common chamber and ascending vertical vein with aneurysmal dilatation of the vertical vein distal to it. The development of the vertical vein aneurysm could possibly be attributed to the presence of turbulent flow within the vertical vein, distal to the site of stenosis caused by the membranous web.
Stukov Y, Gavrylyshin A, Salo S
… +3 more, Levchyshyna OV, Lazoryshynets V, Jacobs JP
Methodist Debakey Cardiovasc J
· 2025 · PMID 41209852
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Aortic perforation is a rare and potentially fatal complication during percutaneous coronary intervention (PCI). This Interactive CME Case presents the case of a 47-year-old man who developed cardiac tamponade secondary...Aortic perforation is a rare and potentially fatal complication during percutaneous coronary intervention (PCI). This Interactive CME Case presents the case of a 47-year-old man who developed cardiac tamponade secondary to iatrogenic aortic perforation during PCI-a true nightmare.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41181162
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We report a case of a 50-year-old male presenting with class III angina on exertion, where an electrocardiogram-gated coronary computed tomography angiography (CCTA) demonstrated the unique coexistence of a type IV dual...We report a case of a 50-year-old male presenting with class III angina on exertion, where an electrocardiogram-gated coronary computed tomography angiography (CCTA) demonstrated the unique coexistence of a type IV dual left anterior descending artery and a split right coronary artery. This case underscores the importance of CCTA in accurately delineating rare coronary artery anatomical variants to avoid both a misdiagnosis and the risk of potential catastrophic outcomes during interventional or surgical procedures.
Stukov Y, Gavrylyshin A, Salo S
… +3 more, Levchyshyna OV, Lazoryshynets V, Jacobs JP
Methodist Debakey Cardiovasc J
· 2025 · PMID 41141381
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Pericardiocentesis is associated with occasional infectious complications. Infected coronary artery aneurysms are rare and develop in patients undergoing coronary angiography. We describe a case of a 68-year-old man with...Pericardiocentesis is associated with occasional infectious complications. Infected coronary artery aneurysms are rare and develop in patients undergoing coronary angiography. We describe a case of a 68-year-old man with prior myocardial infarction who presented with shortness of breath and chest pain 2 weeks after upper respiratory infection. After further workup revealed moderate pericardial effusion, the patient underwent pericardiocentesis and coronary angiography, which revealed multivessel coronary artery disease. The patient was transferred for elective surgical revascularization, which revealed a thickened pericardium with purulent pericardial fluid, suggestive of effusive constrictive pericarditis. Due to the risk for infectious complications, percutaneous coronary intervention was planned after antibiotic treatment. Repeat angiography revealed a coronary artery aneurysm in the proximal left anterior descending and diagonal 1 branch bifurcation, which was closed using an Mguard stent (Inspire MD) with an integrated polyethylene terephthalate net. Complete obliteration of the aneurysm was obtained using this approach.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41112313
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A 52-year-old male with a past medical history significant for hypertension, bipolar disorder, tobacco use, gout, homelessness, intravenous drug use, untreated hepatitis C (spontaneous clearance), and human immunodeficie...A 52-year-old male with a past medical history significant for hypertension, bipolar disorder, tobacco use, gout, homelessness, intravenous drug use, untreated hepatitis C (spontaneous clearance), and human immunodeficiency virus presented to the emergency department with complaints of left foot pain and lower back pain. He was found to have fever, mild leukocytosis, and blood cultures with positive methicillin-sensitive infection. Transesophageal echocardiography was performed to check for intracardiac vegetations due to high risk of infective endocarditis. A mobile echo density was seen attached to the Chiari network, leading to diagnosis of Chiari network endocarditis.
Laszlofy L, Bardoczi A, Husvethova D
… +2 more, de la Garza Bravo M, Garami Z
Methodist Debakey Cardiovasc J
· 2025 · PMID 41112312
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Giant cell arteritis (GCA) is the most common form of systemic vasculitis in individuals over 50 years old. The most feared complication of GCA is permanent blindness, which can be prevented by prompt diagnosis and immed...Giant cell arteritis (GCA) is the most common form of systemic vasculitis in individuals over 50 years old. The most feared complication of GCA is permanent blindness, which can be prevented by prompt diagnosis and immediate treatment. For many years, temporal artery biopsy (TAB) was considered the gold standard for diagnosing GCA. However, TAB can produce considerable false negatives if unaffected arterial segments are sampled. Several studies have shown that temporal artery ultrasound (TAUS)-a noninvasive, inexpensive, and quick diagnostic procedure-offers great sensitivity and enables efficient and prompt diagnosis. Additionally, it helps in identifying the diseased arterial segments sampled with TAB. For these reasons, TAUS is an appropriate complement or possible alternative to biopsy. However, the sequence in which these modalities are performed is crucial: performing the TAB first causes occlusion of the temporal artery, making it impossible to properly conduct the TAUS afterwards. Here, we present a case of a 70-year-old woman who showed symptoms indicative of GCA. In this case, the TAB was delayed twice, thereby allowing TAUS to be performed first and promptly. The presence of a halo sign on the TAUS confirmed GCA, which was later validated via TAB. This case highlights the advantages and benefits of conducting the less-invasive TAUS before the TAB.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078859
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Medical robotics has evolved significantly over the past decades, with more robotic systems than ever now in hospitals. The use of robots for surgery has already revolutionized the surgical landscape by providing high ac...Medical robotics has evolved significantly over the past decades, with more robotic systems than ever now in hospitals. The use of robots for surgery has already revolutionized the surgical landscape by providing high accuracy, greater surgeon dexterity, 3-dimensional visualization capabilities, and the potential for telesurgery. At the same time, diverse medical imaging modalities such as X-ray, computed tomography, magnetic resonance imaging, and ultrasound can provide meaningful visual information required for pre- and intraoperative planning and guidance, which is particularly important for robotic surgery given the surgeon's limited direct view of the surgical workspace in minimally invasive procedures. This review provides an overview of robotics technology for surgery and image acquisition and describes the main steps involved in the processing of medical imaging and its use. The authors also share their views on what the future of robotics and imaging may look like for surgical applications given the recent advances in artificial intelligence, computer vision, and machine learning.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078856
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This report highlights the advanced imaging capabilities of photon counting computed tomography angiography combined with cinematic rendering in evaluating a complex aortic dissection with a type IIIa endoleak secondary...This report highlights the advanced imaging capabilities of photon counting computed tomography angiography combined with cinematic rendering in evaluating a complex aortic dissection with a type IIIa endoleak secondary to modular disjunction of an elephant-trunk endograft.
Pomozi E, Quintero-Peña C, Csore J
… +4 more, Crichton A, Wang G, Karmonik C, Roy T
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078855
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Recent years have brought increasing development of artificial intelligence (AI)-based approaches aimed at optimizing clinical decision-making in vascular medicine. Models increasingly facilitate diagnostic interpretatio...Recent years have brought increasing development of artificial intelligence (AI)-based approaches aimed at optimizing clinical decision-making in vascular medicine. Models increasingly facilitate diagnostic interpretation, treatment planning, and prognosis prediction, particularly in complex cases of peripheral artery disease (PAD). In parallel, a major effort to integrate deep learning methods and imaging modalities has led to new opportunities for using anatomical data to enhance diagnostic capabilities. Among these modalities, magnetic resonance imaging (MRI) is gaining popularity as a noninvasive, nonionizing imaging tool with excellent soft tissue contrast and plaque characterization capabilities. Unlike conventional imaging, MRI can provide information on vascular composition-eg, soft tissue, fibrosis, and calcification-without exposing PAD patients to ionizing radiation and thus is an especially desirable modality for serial monitoring and long-term follow-up of PAD. In this review, we present an overview of the current state of AI integration with MRI in vascular imaging, with a particular focus on PAD. We also introduce several contributions from our research group, with our uniquely designed MRI protocol that incorporates ultrashort echo time and multicontrast sequences to improve vascular tissue characterization in PAD. These high-resolution datasets have served as the foundation for the development of deep learning-based classification systems, including both supervised and unsupervised models. Specifically, we describe how variational autoencoders and hybrid scoring systems have been used to phenotype PAD lesions and predict procedural factors such as guidewire crossability. Our work represents a step toward more objective, reproducible, and clinically interpretable tools that bridge high-fidelity imaging with scalable, AI-driven analysis.
Enamait B, Matherne M, Garmon S
… +4 more, Mascarenhas C, Sharp C, Martinez G, Gallagher C
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078854
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This Points to Remember column outlines the foundational strategies, technological integrations, and early outcomes that shaped our cardiovascular surgery program's initial success when opening a smart hospital in March...This Points to Remember column outlines the foundational strategies, technological integrations, and early outcomes that shaped our cardiovascular surgery program's initial success when opening a smart hospital in March 2025. Houston Methodist Cypress leveraged advanced artificial intelligence-driven systems to improve surgical outcomes and optimize patient care through real-time data integration with electronic health records. These tools were foundational to the hospital's design, resulting in optimization of patient-centered care through sustainable practices and efficiencies.
Monsky WL, James RC, Unni Krishnan A
… +1 more, Seslar SP
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078853
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Echocardiography and ultrasonography are mainstay imaging modalities for the diagnosis, management, and surveillance of widespread acute and chronic illnesses, including cardiovascular disease. As such, they contribute t...Echocardiography and ultrasonography are mainstay imaging modalities for the diagnosis, management, and surveillance of widespread acute and chronic illnesses, including cardiovascular disease. As such, they contribute to improved outcomes. Skilled sonographers are currently required to perform complete diagnostic exams; however, a critical shortage of sonographers in isolated, rural, remote, and global locations contributes to known healthcare disparities. Telerobotic ultrasound systems, which assist sonographers in using a robotic arm to examine patients remotely, offers a potentially profound impact. While this approach represents the intersection of telehealth, robotics, and imaging, important logistics must be addressed to achieve widespread adoption. These include integration of systems and workflow, the need for robust networks, cybersecurity, haptic feedback, cost/billing, and regulatory aspects. The utility, development, technical requirements, and future applications for these technologies are described here.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078852
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This literature review provides a comprehensive clinical perspective on the current and potential role of robotic-assisted surgery within vascular practice. It outlines the historical development and technical components...This literature review provides a comprehensive clinical perspective on the current and potential role of robotic-assisted surgery within vascular practice. It outlines the historical development and technical components of surgical robotic platforms, particularly the da Vinci system, and reviews published evidence on robotic-assisted vascular procedures. It also examines the advantages and limitations of robotic approaches compared to open and endovascular techniques, the current absence of dedicated robotic tools for vascular use, and the growing need for structured training pathways.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078851
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Advancements in intraoperative data acquisition and analytics are transforming surgical care by integrating diverse information streams into cohesive, real-time decision-support systems. This review explores the use of p...Advancements in intraoperative data acquisition and analytics are transforming surgical care by integrating diverse information streams into cohesive, real-time decision-support systems. This review explores the use of physiological monitoring, medical imaging, instrument motion data, surgical video, and environmental metrics within next-generation operating rooms. Traditional vital sign monitoring is now augmented by wearable and minimally invasive technologies capable of continuously capturing respiratory rate, heart rate, skin temperature, and hemodynamic parameters such as stroke volume, cardiac output, systemic vascular resistance, and mean arterial pressure. Real-time imaging modalities including intraoperative cone-beam computed tomography, 3-dimensional fluoroscopy with image fusion, ultrasound, and Doppler systems provide dynamic anatomical context to guide precision interventions. Concurrently, computer vision and artificial intelligence tools are being applied to surgical video and kinematic data to identify procedural phases, assess performance, and recognize critical events. Predictive analytics models, trained on large procedural datasets, can anticipate adverse outcomes like excessive blood loss or prolonged operative time, enhancing intraoperative awareness. Smart operating room platforms integrate these multimodal data sources into centralized interfaces, enabling synchronized documentation, workflow coordination, and team communication. Moreover, emerging concepts such as patient-specific surgical simulation and digital twin models offer personalized guidance and outcome forecasting. Despite these advances, challenges remain in managing data overload, achieving system interoperability, ensuring regulatory compliance, and safeguarding privacy.
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078850
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Philip Alexander, MD, is a native Texan, retired physician, and accomplished musician and artist. After 41 years as an internal medicine physician, Dr. Phil retired from his practice in College Station in 2016. A lifelon...Philip Alexander, MD, is a native Texan, retired physician, and accomplished musician and artist. After 41 years as an internal medicine physician, Dr. Phil retired from his practice in College Station in 2016. A lifelong musician and former music professor, he often performs as an oboe soloist for the Brazos Valley Symphony Orchestra. He began exploring visual art in 1980, evolving from pencil sketches-including an official White House portrait of President Ronald Reagan-to the computer-generated drawings featured in this journal. His images, which first appeared in this journal in the spring of 2012, are his own original creations. This issue of the journal also includes an artistic submission by Aryan Rezvani, MD, a graduate of the Texas A&M School of Medicine, who completed his clerkship rotations at Houston Methodist Hospital. He is now a second-year internal medicine resident at the Baylor College of Medicine. He writes, "I drew this portrait of my younger brother, who was just recently accepted to medical school, starting the path to physicianhood." If you would like to see your art published in the , submit your creation online at journal.houstonmethodist.org as a "Humanities" entry.
Laughlin JL, Johnson LR, Ghanekar B
… +1 more, O'Malley MK
Methodist Debakey Cardiovasc J
· 2025 · PMID 41078849
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Robot-assisted minimally invasive surgery (RAMIS) offers numerous benefits over traditional open surgery, resulting in greater prevalence of use and range of approved procedures. The proliferation of RAMIS has highlighte...Robot-assisted minimally invasive surgery (RAMIS) offers numerous benefits over traditional open surgery, resulting in greater prevalence of use and range of approved procedures. The proliferation of RAMIS has highlighted a need for effective, robust, and objective methods for assessing robotic surgical skills. Traditionally, assessment has relied on expert observation using structured grading rubrics. Although validated and widely used, this method is also resource intensive and subject to reviewer bias. In response, recent work has explored the potential for more robust assessment methods, including the development of skill-based metrics, crowd-sourced assessment techniques, and automated evaluation systems. This review summarizes recent developments in robotic surgical technical skill assessment, focusing on studies using the da Vinci platform. Assessment methods are grouped into four categories: structured rubrics, skill-based metrics, crowd-sourcing techniques, and automated assessment models. Trends of note include adaptation of established rubrics for specific areas of specialty, the implementation of deep learning models for automated assessment, and a move to integrate crowd-sourcing platforms for efficient and inexpensive evaluation. While traditional grading rubric structures remain the standard, multilevel assessment strategies and objective feedback systems are gaining traction. Future work should seek to integrate task- and movement-based assessment into procedure-level evaluations to create more robust and generalizable models for assessment. These advances show a shift towards data-driven and objective assessment methods, which could improve surgical training and patient outcomes.